Search

Background Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated. These injured men are typically transported to a hospital where they are medically stabilized and soon after are returned to the community. Black men are less likely to be discharged to comprehensive rehabilitation facilities, magnifying disparities in recovery from injury. While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors. Purpose The purpose of this study was to describe Black men's perceptions of how characteristics of their environment affect their recovery following serious injury. Methods This was a secondary analysis of an existing data set consisting of semi-structured, qualitative interviews of 43 injured Black men in a northeastern city. The interviews were conducted three months following discharge from a large urban trauma center, and were audiotaped, transcribed verbatim, and de-identified. Thematic analysis consistent with the qualitative paradigm was used to identify themes. Results Four themes were identified in injured men's narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery. Conclusions Our findings emphasize the importance of the role of community resources that can support injured men's recovery within their neighborhoods. Additional resources should be directed to survivors who return to disadvantaged communities after injury in order to minimize adverse emotional experiences that detract from recovery.

Background Injury is not evenly distributed across race and class. In the U.S., urban Black men are at high risk for injury and poor outcomes from injury. Our purpose was to examine the contribution of adverse childhood experiences (ACEs) to post traumatic stress disorder (PTSD) and depression after recent serious physical injury in Black men. Methods This prospective, cohort follow-up study consecutively enrolled adult Black men hospitalised for serious injury at a Level I Trauma Centre. Men with head injury or currently receiving medical treatment for PTSD or depression, and those in police custody were excluded. ACES (7) were collected by self-report during the intake interview. The outcomes of PTSD (measured by the PCL-C) and depression (measured by the QID-SR 16 ) were collected during in-person interviews in the men’s homes 3 months after hospital discharge. Results 320 (mean age = 36.8 years) were enrolled. Injury was classified as unintentional (50%) or intentional, i.e. the result of interpersonal violence (50%). The mean number of ACEs did not differ between intentional and unintentional injuries (2.64 vs. 2.35, p = 0.187). 81% reported at least 1 ACE, 45% reported 3 or more ACEs and 34% reported > 4 ACEs. Intentional injuries were associated with higher mean PCL-C scores (42.4 vs. 33.7, p Conclusions This sample of urban Black men reported substantial histories of childhood trauma and adversity. Results provide evidence that adverse childhood experiences increase the risk for depression and PTSD after serious injury. (Funded: NIH R01NR013503 to Dr. Richmond)